Speech-language pathologists (SLPs) offer many services to children with speech or language disabilities.
Speech-language pathology Speech-language pathologists (SLPs) may provide individual therapy for the child to assist with speech production problems such as stuttering. They may consult with the child's teacher about ways in which the child might be accommodated in the classroom, or modifications that might be made in instruction or environment. A modification may be allowing a communication device or extended testing time. The SLP can also make crucial connections with the family, and help them to establish goals and techniques to be used in the home. Other service providers, such as counselors or vocational instructors may also be included in the development of goals as the child transitions into adulthood. For children with
language disorders, professionals often relate the treatment plans to classroom content, such as classroom textbooks or presentation assignments. The professional teaches various strategies to the child, and the child works to apply them effectively in the classroom. For success in the educational environment, it is imperative that the SLP or other speech-language professional have a strong, positive rapport with the teacher(s). Speech-language pathologists create plans that cater to the individual needs of the patient. If speech is not practical for a patient, the SLP will work with the patient to decide upon an
augmentative and alternative communication (AAC) method or device to facilitate communication. They may work with other patients to help them make sounds, improve voices, or teach general communication strategies. They also work with individuals who have difficulties swallowing. In addition to offering these types of communication training services, SLPs also keep records of evaluation, progress, and eventual discharge of patients, and work with families to overcome and cope with communication impairments (Bureau of Labor Statistics, 2009). In many cases, SLPs provide direct clinical services to individuals with communication or swallowing disorders. SLPs work with physicians, psychologists, and social workers to provide services in the medical domain, and collaborate with educational professionals to offer additional services for students to facilitate the educational process. Thus, speech-language services may be found in schools, hospitals, outpatient clinics, and nursing homes, among other settings. The setting in which therapy is provided to the individual depends upon the age, type, and severity of the individual's impairment. An infant/toddler may engage in an early intervention program, in which services are delivered in a naturalistic environment in which the child is most comfortable—probably his/her home. If the child is school-aged, he/she may receive speech-language services at an outpatient clinic, or even at his/her home school as part of a weekly program. The type of setting in which therapy is offered depends largely upon characteristics of the individual and his/her disability. As with any professional practice that is informed by ongoing research, controversies exist in the fields that deal with speech and language disorders. One such current debate relates to the efficacy of oral motor exercises and the expectations surrounding them. According to Lof, non-speech oral motor exercises (NS-OME) includes "any technique that does not require the child to produce a speech sound but is used to influence the development of speaking abilities". These sorts of exercises would include blowing, tongue push-ups, pucker-smile, tongue wags, big smile, tongue-to-nose-to-chin, cheek puffing, blowing kisses, and tongue curling, among others. Lof continues, indicating that 85% of SLPs are currently using NS-OME. Additionally, these exercises are used for dysarthria, apraxia, late talkers, structural anomalies, phonological impairments, hearing impairments, and other disorders. Practitioners assume that these exercises will strengthen articulatory structures and generalize to speech acts. Lof reviews 10 studies, and concludes that only one of the studies shows benefits to these exercises (it also suffered serious methodological flaws). Lof ultimately concludes that the exercises employ the same structures, but are used for different functions. The NS-OME position is not without its supporters, however, and the proponents are numerous.
Interventions Intervention services will be guided by the strengths and needs determined by the speech and language evaluation. The areas of need may be addressed individually until each one is functional; alternatively, multiple needs may be addressed simultaneously through the intervention techniques. If possible, all interventions will be geared towards the goal of developing typical communicative interaction. To this end, interventions typically follow either a preventive, remedial, or compensatory model. The preventive service model is common as an early intervention technique, especially for children whose other disorders place them at a higher risk for developing later communication problems. This model works to lessen the probability or severity of the issues that could later emerge. The remedial model is used when an individual already has a speech or language impairment that he/she wishes to have corrected. Compensatory models would be used if a professional determines that it is best for the child to bypass the communication limitation; often, this relies on AAC. Language intervention activities are used in some therapy sessions. In these exercises, an SLP or other trained professional will interact with a child by working with the child through play and other forms of interaction to talk to the child and model language use. The professional will make use of various stimuli, such as books, objects, or simple pictures to stimulate the emerging language. In these activities, the professional will model correct pronunciation, and will encourage the child to practice these skills. The specific sounds will be modeled for the child by the professional (often the SLP), and the specific processes involved in creating those sounds will be taught as well. For example, the professional might instruct the child in the placement of the tongue or lips in order to produce certain consonant sounds. Technology is another avenue of intervention, and can help children whose physical conditions make communication difficult. These devices are equipped with assistive technology features that enable the user to express themself, interact with peers, and be able to participate in all aspects of life.
Adaptability and limitations While some speech problems, such as certain voice problems, require medical interventions, many speech problems can be alleviated through effective behavioral interventions and practice. In these cases, instruction in speech techniques or speaking strategies, coupled with regular practice, can help the individual to overcome his/her speaking difficulties. In other, more severe cases, the individual with speech problems may compensate with AAC devices.
Inclusion vs. exclusion Students identified with a speech and language disability often qualify for an
Individualized Education Plan as well as particular services. These include one-on-one services with a speech and language pathologist. Examples used in a session include reading vocabulary words, identifying particular
vowel sounds and then changing the context, noting the difference. School districts in the United States often have speech and language pathologists within a special education staff to work with students. Additionally, school districts can place students with speech and language disabilities in a
resource room for individualized instruction. A combination of early intervention and individualized support has shown promise increasing long-term academic achievement with students with this disability. Students might work individually with a specialist, or with a specialist in a group setting. In some cases, the services provided to these individuals may even be provided in the regular education classroom. Regardless of where these services are provided, most of these students spend small amounts of time in therapy and the large majority of their time in the regular education classroom with their typically developing peers. Therapy often occurs in small groups of three or four students with similar needs. Meeting either in the office of the speech-language pathologist or in the classroom, sessions may take from 30 minutes to one hour. They may occur several times per week. After introductory conversations, the session is focused on a particular therapeutic activity, such as coordination and strengthening exercises of speech muscles or improving fluency through breathing techniques. These activities may take the form of games, songs, skits, and other activities that deliver the needed therapy. Aids, such as mirrors, tape recorders, and tongue depressors may be utilized to help the children to become aware of their speech sounds and to work toward more natural speech production. ==Prevalence==